Scared Sleepless

I've read your article about sleep talking and wanted to share my recent experience with you because I'm quite confused.

I started dating a man 3 months ago. At that time, he told me that he sometimes talks in his sleep.

Everything was going fine until recently. He would indeed talk in his sleep every now and then, mostly about things that had happened to him during the day, or about other ordinary topics.

This changed several nights ago. He stood up while still in bed, turned his head towards me (I couldn't see if his eyes were open because it was dark) and he asked me “Who the hell are you?” He repeated this 3-4 times, all the while looking right at me. I didn't say anything, mainly because I was frightened.

My question is: Could this be a sign of a more serious problem than just some regular sleep talking? Is it normal that people actually LOOK at you while they are asleep? What is the best thing to do in such situations?

Thank you in advance,

Yours faithfully,

Sleepless in Stockholm

Dear Sleepless,

What you’re describing sounds like a confusional arousal (albeit a disturbing one). Confusional arousals usually occur in the first portion of the night, when the drive to sleep is strongest. Normally, we all cycle through the different stages of sleep, shifting from deep to light to REM (rapid eye movement) sleep and even awakening briefly now and then before quickly returning to sleep.

Occasionally, however, part of our brain awakens while other parts remain fast asleep. When this occurs, strange things happen: sleep walking, sleep eating, night terrors, and sleep talking. It’s not uncommon for people to carry on conversations with people who aren’t there, or to speak of things wholly unrelated to what is happening around them. Invariably, there is no recollection of this the following morning.

While the vast majority of confusional arousals result in no harm to the person experiencing them, or to those who witness them, they do sometimes result in injury, such as when a person sleepwalks out of a window, or wanders away from the house on a cold winter’s night. Therefore, the most important thing to do is make sure that the person experiencing the confusional arousal is safe. If they tend to sleep walk, for example, it is important to prevent them from banging into furniture, falling down stairs, etc. There is no need to try an awaken them: the best is to simply guide them back to bed where they’ll be safe, and to let them fall completely back to sleep.

There have been isolated reports of physical and sexual assaults being committed by people in a fugue-like state of confusional arousal. However, these are very rare. Still, if you are concerned, it may be a good idea for your boyfriend to consider discussing this with his doctor, as there are medicines which can decrease the likelihood of confusional arousals from occurring in the first place. In parallel to this, keeping to a regular schedule, getting enough sleep, and stress relief prior to sleep may also help to reduce their incidence, and to help you both get a better night’s sleep.

I was a sleepwalker, and I talked, and ate for many years during those episodes when I was a child and had few of them being an adult and also I have migraines for many years. After having my first child when I was twenty eight years-old, I took a bus in a six million people city in Latin America at noon on a Saturday, crossed a three line bus/car avenue and leaned on a store wall closed to my apartment, where the clerks called the police, and the policeman took me home, because it looked that I was talking all the time although I never remembered. where I was until I was in my apartment with a terrible migraine; the next Monday I talked to a colleague neurologist at the hospital where I was working as a radiologist oncologist and described what happened to me. I had an EEG, and it showed that I had an epileptic focus in the left temporal lobe (it showed with the flashing light), which explained my sleepwalking (automatisms), the migraines, and the sleep talking; the neurologist prescribed anticonvulsants and my symptoms improved.
Maybe, this young man should be seen by a neurologist, because like my neurologist told me, many people that have this kind of problem have more chances to be hurt than to hurt somebody.

Many parts of this article remind me of the National Geographic's video on sleepwalking. For example, in Dr. Rosen's second pararaph he lists the odd occurences that happen during sleep, including sleepwalking, sleep eating, sleep terrors and sleeptalking, which not only take place in the video but are also explained in the book. Sleepwalking, sleep-eating disorders and others are examples of parasomnia, which shows that sleeping and awake states can overlap. Also, in his last paragraph he states that there have been reported incidents like these that have caused physical harm, and we saw some of these in the video, like the so called "sleepwalking murders" and the young lady who said she would find bruises and cuts on herself from falling or running into things.
One thing that stuck out most to me is how the incident she is describing about her boyfriend sounds like he is suffering from sleep terrors. Sleep terrors usually occur during the first couple hours of sleep, just as Dr. Rosen said, and the person suffering from them suddenly sits up in bed and lets out a cry of distress, and to me his violently asking who she is seems to show his distress. In addition, they are breif and the person tends to not remember the incidents at all.